﻿<%@ Page Title="" Language="C#" MasterPageFile="~/Provider/PersonalAccident/PersonalAccident.master" AutoEventWireup="true" CodeFile="AddNewPAInsurance.aspx.cs" Inherits="Provider_PersonalAccident_AddNewPAInsurance" %>

<asp:Content ID="Content1" ContentPlaceHolderID="ContentPlaceHolder1" Runat="Server">
    <asp:ScriptManager ID="ScriptManager" runat="server"></asp:ScriptManager>
<div class="provider_inner">
        <h1>
            Personal Accident Insurance
            <asp:Label ID="lblPAInsId" runat="server" Text="0" Visible="false"></asp:Label>
        </h1>
        <fieldset>
            <asp:UpdatePanel ID="uPanelfield" runat="server">
            <ContentTemplate>
            <dl>
                <dt>
                    <label>
                        Plan Name</label></dt>
                <dd>
                    <asp:TextBox ID="txtPlanName" runat="server" MaxLength="25" Width="250px"></asp:TextBox>
                    <asp:RequiredFieldValidator ID="rfvPlanName" runat="server" ControlToValidate="txtPlanName"
                        ErrorMessage="Require Plan Name." ValidationGroup="addnewpains">*</asp:RequiredFieldValidator>
                </dd>
            </dl>
            <dl>
                <dt>
                    <label>
                        Benefit Name</label></dt>
                <dd>
                    <asp:TextBox ID="txtBenefitName" runat="server" MaxLength="25" Width="250px"></asp:TextBox>
                    <asp:RequiredFieldValidator ID="rfvBenefitName" runat="server" ControlToValidate="txtBenefitName"
                        ErrorMessage="Require Plan Name." ValidationGroup="addnewpains">*</asp:RequiredFieldValidator>
                </dd>
            </dl>
            <dl>
                <dt>
                    <label>
                        Occupation Class</label></dt>
                <dd>
                    <asp:CheckBox ID="chkClass1" runat="server" Text="Class 1" />&nbsp;&nbsp;
                    <asp:CheckBox ID="chkClass2" runat="server" Text="Class 2" />&nbsp;&nbsp;
                    <asp:CheckBox ID="chkClass3" runat="server" Text="Class 3" />&nbsp;&nbsp;
                    <asp:CheckBox ID="chkClass4" runat="server" Text="Class 4" />
                    <%--<asp:RequiredFieldValidator ID="rfvClass" runat="server" ControlToValidate="txtClass"
                        ErrorMessage="*" ValidationGroup="addnewpains">*</asp:RequiredFieldValidator>--%>
                    <div style="display: ;">
                        <asp:TextBox ID="txtClass" runat="server" Visible="false"></asp:TextBox>
                    </div>
                </dd>
            </dl>
            <dl>
                <dt>
                    <label>
                        Policy/Plan Type</label></dt>
                <dd>
                    <asp:DropDownList ID="ddlPolicyType" runat="server" class="text" Width="255px" 
                        onselectedindexchanged="ddlPolicyType_SelectedIndexChanged" AutoPostBack="true">
                        <asp:ListItem Selected="True" Value="-1">Select</asp:ListItem>
                        <asp:ListItem Value="IND">Individual</asp:ListItem>
                        <asp:ListItem Value="INDSP">Individual & Spouse</asp:ListItem>
                        <asp:ListItem Value="INDCHD">Individual & Children</asp:ListItem>
                        <asp:ListItem Value="INDSPCHD">Individual, Spouse & Children</asp:ListItem>
                    </asp:DropDownList>
                    <asp:RequiredFieldValidator ID="rfvPolicyType" runat="server" ErrorMessage="*" ControlToValidate="ddlPolicyType"
                        InitialValue="-1" ValidationGroup="addnewpains"></asp:RequiredFieldValidator>
                </dd>
            </dl>
            <h3>Annual Premium</h3>
            <dl>
                <dt>
                    <label>
                        Annual Premium(Individual / Common)</label></dt>
                <dd>
                    <asp:TextBox ID="txtAnnualPremium" runat="server" MaxLength="20" Width="150px"></asp:TextBox>$
                    <asp:RequiredFieldValidator ID="rfvAnnualPremium" runat="server" ControlToValidate="txtAnnualPremium"
                        ErrorMessage="*" ValidationGroup="addnewpains">*</asp:RequiredFieldValidator>
                    <asp:RegularExpressionValidator ID="revAnnualPremium" runat="server" ControlToValidate="txtAnnualPremium"
                        ErrorMessage="Enter Number value." ValidationExpression="^[0-9]+(\.[0-9]{1,2})?$" ValidationGroup="addnewpains"></asp:RegularExpressionValidator>
                </dd>
            </dl>
            <asp:Panel ID="pnlAPSpouse" runat="server" Visible="false">
            <dl>
                <dt>
                    <label>
                        Annual Premium (Spouse)</label></dt>
                <dd>
                    <asp:TextBox ID="txtAnnualPremiumSpouse" runat="server" MaxLength="20" Width="150px"></asp:TextBox>$
                    <asp:RegularExpressionValidator ID="revAnnualPremiumSpouse" runat="server" ControlToValidate="txtAnnualPremiumSpouse"
                        ErrorMessage="Enter Number value." ValidationExpression="^[0-9]+(\.[0-9]{1,2})?$" ValidationGroup="addnewpains"></asp:RegularExpressionValidator>
                </dd>
            </dl>    
            </asp:Panel>
            <asp:Panel ID="pnlAPChild" runat="server" Visible="false">
            <dl>
                <dt>
                    <label>
                        Annual Premium (Child)</label></dt>
                <dd>
                    <asp:TextBox ID="txtAnnualPremiumChild" runat="server" MaxLength="20" Width="150px"></asp:TextBox>$
                    <asp:RegularExpressionValidator ID="revAnnualPremiumChild" runat="server" ControlToValidate="txtAnnualPremiumChild"
                        ErrorMessage="Enter Number value." ValidationExpression="^[0-9]+(\.[0-9]{1,2})?$" ValidationGroup="addnewpains"></asp:RegularExpressionValidator>
                </dd>
            </dl>    
            </asp:Panel>
            <h3>Accidental Death</h3>
            <dl>
                <dt>
                    <label>
                        Accidental Death (Adult)</label></dt>
                <dd>
                    <asp:TextBox ID="txtAccidentalDeathAdult" runat="server" MaxLength="20" Width="150px"></asp:TextBox>$
                    <asp:RequiredFieldValidator ID="rfvAccidentalDeathAdult" runat="server" ControlToValidate="txtAccidentalDeathAdult"
                        ErrorMessage="*" ValidationGroup="addnewpains">*</asp:RequiredFieldValidator>
                    <asp:RegularExpressionValidator ID="revAccidentalDeathAdult" runat="server" ControlToValidate="txtAccidentalDeathAdult"
                        ErrorMessage="Enter Number value." ValidationExpression="^[0-9]+(\.[0-9]{1,2})?$" ValidationGroup="addnewpains"></asp:RegularExpressionValidator>
                </dd>
            </dl>
            <asp:Panel ID="pnlAcciDeathChild" runat="server" Visible="false">
            <dl>
                <dt>
                    <label>
                        Accidental Death (Child)</label></dt>
                <dd>
                    <asp:TextBox ID="txtAccidentalDeathChild" runat="server" MaxLength="20" Width="150px"></asp:TextBox>$
                    <asp:RequiredFieldValidator ID="rfvAccidentalDeathChild" runat="server" ControlToValidate="txtAccidentalDeathChild"
                        ErrorMessage="*" Enabled="false" ValidationGroup="addnewpains">*</asp:RequiredFieldValidator>
                    <asp:RegularExpressionValidator ID="revAccidentalDeathChild" runat="server" ControlToValidate="txtAccidentalDeathChild"
                        ErrorMessage="Enter Number value." ValidationExpression="^[0-9]+(\.[0-9]{1,2})?$" ValidationGroup="addnewpains" Enabled="false"></asp:RegularExpressionValidator>
                </dd>
            </dl>
            </asp:Panel>
            <h3>Total Premanent Disablement</h3>
            <dl>
                <dt>
                    <label>
                        Total Premanent Disablement (Adult)</label></dt>
                <dd>
                    <asp:TextBox ID="txtTotPerDisableAdult" runat="server" MaxLength="20" Width="150px"></asp:TextBox>$
                    <asp:RequiredFieldValidator ID="rfvTotPerDisableAdult" runat="server" ControlToValidate="txtTotPerDisableAdult"
                        ErrorMessage="*" ValidationGroup="addnewpains">*</asp:RequiredFieldValidator>
                    <asp:RegularExpressionValidator ID="revTotPerDisableAdult" runat="server" ControlToValidate="txtTotPerDisableAdult"
                        ErrorMessage="Enter Number value." ValidationExpression="^[0-9]+(\.[0-9]{1,2})?$" ValidationGroup="addnewpains"></asp:RegularExpressionValidator>
                </dd>
            </dl>
            <asp:Panel ID="pnlTotPerDisableChild" runat="server" Visible="false">
            <dl>
                <dt>
                    <label>
                        Total Premanent Disablement (Child)</label></dt>
                <dd>
                    <asp:TextBox ID="txtTotPerDisableChild" runat="server" MaxLength="20" Width="150px"></asp:TextBox>$
                    <asp:RequiredFieldValidator ID="rfvTotPerDisableChild" runat="server" ControlToValidate="txtTotPerDisableChild"
                        ErrorMessage="*" Enabled="false" ValidationGroup="addnewpains">*</asp:RequiredFieldValidator>
                    <asp:RegularExpressionValidator ID="revTotPerDisableChild" runat="server" ControlToValidate="txtTotPerDisableChild"
                        ErrorMessage="Enter Number value." ValidationExpression="^[0-9]+(\.[0-9]{1,2})?$" ValidationGroup="addnewpains" Enabled="false"></asp:RegularExpressionValidator>
                </dd>
            </dl>
            </asp:Panel>
            <h3>Medical Expenses</h3>
            <dl>
                <dt>
                    <label>
                        <asp:CheckBox ID="cbIsMedicalExpA" runat="server" />
                        <i class="blackfont">not applicable</i>
                    </label>
                </dt>
                <dd>
                </dd>
            </dl>
            <dl>
                <dt>
                    <label>
                        Medical Expenses (Adult)</label></dt>
                <dd>
                    <asp:TextBox ID="txtMedicalExpensesAdult" runat="server" MaxLength="20" Width="150px"></asp:TextBox>$
                    <asp:RequiredFieldValidator ID="rfvMedicalExpensesAdult" runat="server" ControlToValidate="txtMedicalExpensesAdult"
                        ErrorMessage="*" ValidationGroup="addnewpains">*</asp:RequiredFieldValidator>
                    <asp:RegularExpressionValidator ID="revMedicalExpensesAdult" runat="server" ControlToValidate="txtMedicalExpensesAdult"
                        ErrorMessage="Enter Number value." ValidationExpression="^[0-9]+(\.[0-9]{1,2})?$" ValidationGroup="addnewpains"></asp:RegularExpressionValidator>
                </dd>
            </dl>
            <asp:Panel ID="pnlMedicalExpensesChild" runat="server" Visible="false">
            <dl>
                <dt>
                    <label>
                        <asp:CheckBox ID="cbIsMedicalExpC" runat="server" />
                        <i class="blackfont">not applicable</i>
                    </label>
                </dt>
                <dd>
                </dd>
            </dl>
            <dl>
                <dt>
                    <label>
                        Medical Expenses (Child)</label></dt>
                <dd>
                    <asp:TextBox ID="txtMedicalExpensesChild" runat="server" MaxLength="20" Width="150px"></asp:TextBox>$
                    <asp:RequiredFieldValidator ID="rfvMedicalExpensesChild" runat="server" ControlToValidate="txtMedicalExpensesChild"
                        ErrorMessage="*" Enabled="false" ValidationGroup="addnewpains">*</asp:RequiredFieldValidator>
                    <asp:RegularExpressionValidator ID="revMedicalExpensesChild" runat="server" ControlToValidate="txtMedicalExpensesChild"
                        ErrorMessage="Enter Number value." ValidationExpression="^[0-9]+(\.[0-9]{1,2})?$" ValidationGroup="addnewpains" Enabled="false"></asp:RegularExpressionValidator>
                </dd>
            </dl>
            </asp:Panel>
            <dl>
                <dt>
                    <label>
                        <asp:CheckBox ID="cbIsDentalTreatment" runat="server" />
                        <i class="blackfont">not applicable</i>
                    </label>
                </dt>
                <dd>
                </dd>
            </dl>
            <dl>
                <dt>
                    <label>
                        DentalTreatment</label></dt>
                <dd>
                    <asp:TextBox ID="txtDentalTreatment" runat="server" MaxLength="20" Width="150px"></asp:TextBox>$
                    <asp:RequiredFieldValidator ID="rfvDentalTreatment" runat="server" ControlToValidate="txtDentalTreatment"
                        ErrorMessage="*" ValidationGroup="addnewpains">*</asp:RequiredFieldValidator>
                    <asp:RegularExpressionValidator ID="revDentalTreatment" runat="server" ControlToValidate="txtDentalTreatment"
                        ErrorMessage="Enter Number value." ValidationExpression="^[0-9]+(\.[0-9]{1,2})?$" ValidationGroup="addnewpains"></asp:RegularExpressionValidator>
                </dd>
            </dl>
            <dl>
                <dt>
                    <label>
                        <asp:CheckBox ID="cbIsChineseMedicalExpenses" runat="server" />
                        <i class="blackfont">not applicable</i>
                    </label>
                </dt>
                <dd>
                </dd>
            </dl>
            <dl>
                <dt>
                    <label>
                        Chinese Medical Expenses</label></dt>
                <dd>
                    <asp:TextBox ID="txtChineseMedicalExpenses" runat="server" MaxLength="20" Width="150px"></asp:TextBox>$
                    <asp:RequiredFieldValidator ID="rfvChineseMedicalExpenses" runat="server" ControlToValidate="txtChineseMedicalExpenses"
                        ErrorMessage="*" ValidationGroup="addnewpains">*</asp:RequiredFieldValidator>
                    <asp:RegularExpressionValidator ID="revChineseMedicalExpenses" runat="server" ControlToValidate="txtChineseMedicalExpenses"
                        ErrorMessage="Enter Number value." ValidationExpression="^[0-9]+(\.[0-9]{1,2})?$" ValidationGroup="addnewpains"></asp:RegularExpressionValidator>
                </dd>
            </dl>
            <h3>Hospital Cash Per Day</h3>
            <dl>
                <dt>
                    <label>
                        <asp:CheckBox ID="cbIsHaspitalCPDA" runat="server" />
                        <i class="blackfont">not applicable</i>
                    </label>
                </dt>
                <dd>
                </dd>
            </dl>
            <dl>
                <dt>
                    <label>
                        Hospital Cash Per Day (Adult)</label></dt>
                <dd>
                    <asp:TextBox ID="txtHCashPerDayAdult" runat="server" MaxLength="20" Width="150px"></asp:TextBox>$
                    <asp:RequiredFieldValidator ID="rfvHCashPerDayAdult" runat="server" ControlToValidate="txtHCashPerDayAdult"
                        ErrorMessage="*" ValidationGroup="addnewpains">*</asp:RequiredFieldValidator>
                    <asp:RegularExpressionValidator ID="revHCashPerDayAdult" runat="server" ControlToValidate="txtHCashPerDayAdult"
                        ErrorMessage="Enter Number value." ValidationExpression="^[0-9]+(\.[0-9]{1,2})?$" ValidationGroup="addnewpains"></asp:RegularExpressionValidator>
                </dd>
            </dl>
            <asp:Panel ID="pnlHExpencePerDayChild" runat="server" Visible="false">
            <dl>
                <dt>
                    <label>
                        <asp:CheckBox ID="cbIsHaspitalCPDC" runat="server" />
                        <i class="blackfont">not applicable</i>
                    </label>
                </dt>
                <dd>
                </dd>
            </dl>
            <dl>
                <dt>
                    <label>
                        Hospital Cash Per Day (Child)</label></dt>
                <dd>
                    <asp:TextBox ID="txtHCashPerDayChild" runat="server" MaxLength="20" Width="150px"></asp:TextBox>$
                    <asp:RequiredFieldValidator ID="rfvHCashPerDayChild" runat="server" ControlToValidate="txtHCashPerDayChild"
                        ErrorMessage="*" Enabled="false" ValidationGroup="addnewpains">*</asp:RequiredFieldValidator>
                    <asp:RegularExpressionValidator ID="revHCashPerDayChild" runat="server" ControlToValidate="txtHCashPerDayChild"
                        ErrorMessage="Enter Number value." ValidationExpression="^[0-9]+(\.[0-9]{1,2})?$" ValidationGroup="addnewpains" Enabled="false"></asp:RegularExpressionValidator>
                </dd>
            </dl>
            </asp:Panel>
            <dl>
                <dt>
                    <label>
                        <asp:CheckBox ID="cbIsRecuperation" runat="server" />
                        <i class="blackfont">not applicable</i>
                    </label>
                </dt>
                <dd>
                </dd>
            </dl>
            <dl>
                <dt>
                    <label>
                        Recuperation Benefit</label></dt>
                <dd>
                    <asp:TextBox ID="txtRecupBenefit" runat="server" MaxLength="20" Width="150px"></asp:TextBox>$
                    <asp:RequiredFieldValidator ID="rfvRecupBenefit" runat="server" ControlToValidate="txtRecupBenefit"
                        ErrorMessage="*" ValidationGroup="addnewpains">*</asp:RequiredFieldValidator>
                    <asp:RegularExpressionValidator ID="revRecupBenefit" runat="server" ControlToValidate="txtRecupBenefit"
                        ErrorMessage="Enter Number value." ValidationExpression="^[0-9]+(\.[0-9]{1,2})?$" ValidationGroup="addnewpains"></asp:RegularExpressionValidator>
                </dd>
            </dl>
            <dl>
                <dt>
                    <label>
                        <asp:CheckBox ID="cbIsBereavement" runat="server" />
                        <i class="blackfont">not applicable</i>
                    </label>
                </dt>
                <dd>
                </dd>
            </dl>
            <dl>
                <dt>
                    <label>
                        Bereavement Relief</label></dt>
                <dd>
                    <asp:TextBox ID="txtBereaveRelief" runat="server" MaxLength="20" Width="150px"></asp:TextBox>$
                    <asp:RequiredFieldValidator ID="rfvBereaveRelief" runat="server" ControlToValidate="txtBereaveRelief"
                        ErrorMessage="*" ValidationGroup="addnewpains">*</asp:RequiredFieldValidator>
                    <asp:RegularExpressionValidator ID="revBereaveRelief" runat="server" ControlToValidate="txtBereaveRelief"
                        ErrorMessage="Enter Number value." ValidationExpression="^[0-9]+(\.[0-9]{1,2})?$" ValidationGroup="addnewpains"></asp:RegularExpressionValidator>
                </dd>
            </dl>
            <dl>
                <dt>
                    <label>
                        Double Indemnity</label></dt>
                <dd>
                    <asp:CheckBox ID="chkDoubleIndemnity" runat="server" />
                </dd>
            </dl>
            <dl>
                <dt>
                    <label>
                        <asp:CheckBox ID="cbIsTempTotDisPW" runat="server" />
                        <i class="blackfont">not applicable</i>
                    </label>
                </dt>
                <dd>
                </dd>
            </dl>
            <dl>
                <dt>
                    <label>
                        Temporary Total Disablement(pre week)</label></dt>
                <dd>
                    <asp:TextBox ID="txtTempTotalDisable" runat="server" MaxLength="20" Width="150px"></asp:TextBox>$
                    <asp:RequiredFieldValidator ID="rfvTempTotalDisable" runat="server" ControlToValidate="txtTempTotalDisable"
                        ErrorMessage="*" ValidationGroup="addnewpains">*</asp:RequiredFieldValidator>
                    <asp:RegularExpressionValidator ID="revTempTotalDisable" runat="server" ControlToValidate="txtTempTotalDisable"
                        ErrorMessage="Enter Number value." ValidationExpression="^[0-9]+(\.[0-9]{1,2})?$" ValidationGroup="addnewpains"></asp:RegularExpressionValidator>
                </dd>
            </dl>
            <dl>
                <dt>
                    <label>
                        <asp:CheckBox ID="cbIsTempPartDisPW" runat="server" />
                        <i class="blackfont">not applicable</i>
                    </label>
                </dt>
                <dd>
                </dd>
            </dl>
            <dl>
                <dt>
                    <label>
                        Temporary Partial Disablement(pre week)</label></dt>
                <dd>
                    <asp:TextBox ID="txtTempParialDisable" runat="server" MaxLength="20" Width="150px"></asp:TextBox>$
                    <asp:RequiredFieldValidator ID="rfvTempParialDisable" runat="server" ControlToValidate="txtTempParialDisable"
                        ErrorMessage="*" ValidationGroup="addnewpains">*</asp:RequiredFieldValidator>
                    <asp:RegularExpressionValidator ID="revTempParialDisable" runat="server" ControlToValidate="txtTempParialDisable"
                        ErrorMessage="Enter Number value." ValidationExpression="^[0-9]+(\.[0-9]{1,2})?$" ValidationGroup="addnewpains"></asp:RegularExpressionValidator>
                </dd>
            </dl>
            <dl>
                <dt>
                    <label>
                        <asp:CheckBox ID="cbIsCompassionateCash" runat="server" />
                        <i class="blackfont">not applicable</i>
                    </label>
                </dt>
                <dd>
                </dd>
            </dl>
            <dl>
                <dt>
                    <label>
                        Compassionate Cash</label></dt>
                <dd>
                    <asp:TextBox ID="txtCompassionateCash" runat="server" MaxLength="20" Width="150px"></asp:TextBox>$
                    <asp:RequiredFieldValidator ID="rfvCompassionateCash" runat="server" ControlToValidate="txtCompassionateCash"
                        ErrorMessage="*" ValidationGroup="addnewpains">*</asp:RequiredFieldValidator>
                    <asp:RegularExpressionValidator ID="revCompassionateCash" runat="server" ControlToValidate="txtCompassionateCash"
                        ErrorMessage="Enter Number value." ValidationExpression="^[0-9]+(\.[0-9]{1,2})?$" ValidationGroup="addnewpains"></asp:RegularExpressionValidator>
                </dd>
            </dl>
            <dl>
                <dt>
                    <label>
                        <asp:CheckBox ID="cbIsKidnapBenefit" runat="server" />
                        <i class="blackfont">not applicable</i>
                    </label>
                </dt>
                <dd>
                </dd>
            </dl>
            <dl>
                <dt>
                    <label>
                        Kidnap Benefit</label></dt>
                <dd>
                    <asp:TextBox ID="txtKidnapBenefit" runat="server" MaxLength="20" Width="150px"></asp:TextBox>$
                    <asp:RequiredFieldValidator ID="rfvKidnapBenefit" runat="server" ControlToValidate="txtKidnapBenefit"
                        ErrorMessage="*" ValidationGroup="addnewpains">*</asp:RequiredFieldValidator>
                    <asp:RegularExpressionValidator ID="revKidnapBenefit" runat="server" ControlToValidate="txtKidnapBenefit"
                        ErrorMessage="Enter Number value." ValidationExpression="^[0-9]+(\.[0-9]{1,2})?$" ValidationGroup="addnewpains"></asp:RegularExpressionValidator>
                </dd>
            </dl>
            <dl>
                <dt>
                    <label>
                        Terrorism</label></dt>
                <dd>
                    <asp:CheckBox ID="chkTerrorism" runat="server" />
                </dd>
            </dl>
            <dl>
                <dt>
                    <label>
                        Age Limit From</label></dt>
                <dd>
                    <asp:TextBox ID="txtAgeLimitFrom" runat="server" MaxLength="2" Width="50px"></asp:TextBox>
                    <asp:RequiredFieldValidator ID="rfvAgeLimitFrom" runat="server" ControlToValidate="txtAgeLimitFrom"
                        ErrorMessage="*" ValidationGroup="addnewpains">*</asp:RequiredFieldValidator>
                    <asp:RegularExpressionValidator ID="revAgeLimitFrom" runat="server" ControlToValidate="txtAgeLimitFrom"
                        ErrorMessage="*" ValidationExpression="^[0-9]+(\.[0-9]{1,2})?$" ValidationGroup="addnewpains"></asp:RegularExpressionValidator>
                </dd>
            </dl>
            <dl>
                <dt>
                    <label>
                        Age Limit To</label></dt>
                <dd>
                    <asp:TextBox ID="txtAgeLimitTo" runat="server" MaxLength="2" Width="50px"></asp:TextBox>
                    <asp:RequiredFieldValidator ID="rfvAgeLimitTo" runat="server" ControlToValidate="txtAgeLimitTo"
                        ErrorMessage="*" ValidationGroup="addnewpains">*</asp:RequiredFieldValidator>
                    <asp:RegularExpressionValidator ID="revAgeLimitTo" runat="server" ControlToValidate="txtAgeLimitTo"
                        ErrorMessage="*" ValidationExpression="^[0-9]+(\.[0-9]{1,2})?$" ValidationGroup="addnewpains"></asp:RegularExpressionValidator>
                </dd>
            </dl>
            <dl>
                <dt>
                    <label>
                        Status</label></dt>
                <dd>
                    <asp:CheckBox ID="chkStatus" runat="server" />
                </dd>
            </dl>
            </ContentTemplate>
            </asp:UpdatePanel>
        </fieldset>
        <fieldset class="action">
            <asp:UpdatePanel ID="uPanelaction" runat="server">
            <ContentTemplate>
            <asp:ImageButton OnClientClick="javascript:return confirm('Are you sure to go back?');"
                ID="ibtBack" runat="server" CssClass="left_btn" 
                    ImageUrl="~/Provider/images/buttons/back1.gif" onclick="ibtBack_Click" />
            <asp:ImageButton ID="ibtSubmit" CssClass="float_btn" ValidationGroup="addnewpains"
                runat="server" ImageUrl="~/Provider/images/buttons/submit1.gif" 
                    onclick="ibtSubmit_Click" />
            <asp:ImageButton ID="btnNew" CssClass="floatnext_btn" OnClientClick="return confirm('Are you sure to clear form?');" 
                runat="server" ImageUrl="~/Provider/images/buttons/new1.gif" 
                    onclick="btnNew_Click" />
            <%--<asp:ImageButton ID="btnDelete" CssClass="floatnext_btn" OnClientClick="return confirm('Are you sure you want to remove this record?');" 
                runat="server" ImageUrl="~/Provider/images/buttons/delete1.gif" />--%>
            </ContentTemplate>
            </asp:UpdatePanel>
        </fieldset>
        <asp:Label ID="lblMessage" runat="server" CssClass="successmsg" Text=""></asp:Label>
    </div>
    <script type="text/javascript" language="javascript">
        function ValClass()
        {
            var chkCtrl1 = document.getElementById("<%=chkClass1.ClientID%>");
            var chkCtrl2 = document.getElementById("<%=chkClass2.ClientID%>");
            var chkCtrl3 = document.getElementById("<%=chkClass3.ClientID%>");
            var chkCtrl4 = document.getElementById("<%=chkClass4.ClientID%>");
            var txtCtrl = document.getElementById("<%=txtClass.ClientID%>");
            if(chkCtrl1.cheched || chkCtrl2.cheched || chkCtrl3.cheched  || chkCtrl4.cheched)
            {            
                txtCtrl.value = "1";
            }
            else
            {
                txtCtrl.value = "";
            }
        }

        function MedicalExpenseApplicableA(item) {
            var AMedicalExp = document.getElementById('<%= txtMedicalExpensesAdult.ClientID%>');

            if (item.checked == true) {
                AMedicalExp.disabled = true;
                AMedicalExp.value = '0';
            }
            else {
                AMedicalExp.disabled = false;
            }
        }

        function MedicalExpenseApplicableC(item) {
            var CMedicalExp = document.getElementById('<%= txtMedicalExpensesChild.ClientID%>');

            if (item.checked == true) {
                CMedicalExp.disabled = true;
                CMedicalExp.value = '0';
            }
            else {
                CMedicalExp.disabled = false;
            }
        }

        function HospitalCPDApplicableA(item) {
            var AHospitalCPD = document.getElementById('<%= txtHCashPerDayAdult.ClientID%>');

            if (item.checked == true) {
                AHospitalCPD.disabled = true;
                AHospitalCPD.value = '0';
            }
            else {
                AHospitalCPD.disabled = false;
            }
        }

        function HospitalCPDApplicableC(item) {
            var CHospitalCPD = document.getElementById('<%= txtHCashPerDayChild.ClientID%>');

            if (item.checked == true) {
                CHospitalCPD.disabled = true;
                CHospitalCPD.value = '0';
            }
            else {
                CHospitalCPD.disabled = false;
            }
        }

        function RecuperationApplicable(item) {
            var Recuperation = document.getElementById('<%= txtRecupBenefit.ClientID%>');

            if (item.checked == true) {
                Recuperation.disabled = true;
                Recuperation.value = '0';
            }
            else {
                Recuperation.disabled = false;
            }
        }

        function BereavementApplicable(item) {
            var Bereavement = document.getElementById('<%= txtBereaveRelief.ClientID%>');

            if (item.checked == true) {
                Bereavement.disabled = true;
                Bereavement.value = '0';
            }
            else {
                Bereavement.disabled = false;
            }
        }

        function TempTotDisPWApplicable(item) {
            var TempTotDisPW = document.getElementById('<%= txtTempTotalDisable.ClientID%>');

            if (item.checked == true) {
                TempTotDisPW.disabled = true;
                TempTotDisPW.value = '0';
            }
            else {
                TempTotDisPW.disabled = false;
            }
        }

        function TempPartDisPWApplicable(item) {
            var TempPartDisPW = document.getElementById('<%= txtTempParialDisable.ClientID%>');

            if (item.checked == true) {
                TempPartDisPW.disabled = true;
                TempPartDisPW.value = '0';
            }
            else {
                TempPartDisPW.disabled = false;
            }
        }

        function DentalTreatmentApplicable(item) {
            var DentalTreatment = document.getElementById('<%= txtDentalTreatment.ClientID%>');

            if (item.checked == true) {
                DentalTreatment.disabled = true;
                DentalTreatment.value = '0';
            }
            else {
                DentalTreatment.disabled = false;
            }
        }

        function ChineseMedicalExpensesApplicable(item) {
            var ChineseMedicalExpenses = document.getElementById('<%= txtChineseMedicalExpenses.ClientID%>');

            if (item.checked == true) {
                ChineseMedicalExpenses.disabled = true;
                ChineseMedicalExpenses.value = '0';
            }
            else {
                ChineseMedicalExpenses.disabled = false;
            }
        }

        function CompassionateCashApplicable(item) {
            var CompassionateCash = document.getElementById('<%= txtCompassionateCash.ClientID%>');

            if (item.checked == true) {
                CompassionateCash.disabled = true;
                CompassionateCash.value = '0';
            }
            else {
                CompassionateCash.disabled = false;
            }
        }

        function KidnapBenefitApplicable(item) {
            var KidnapBenefit = document.getElementById('<%= txtKidnapBenefit.ClientID%>');

            if (item.checked == true) {
                KidnapBenefit.disabled = true;
                KidnapBenefit.value = '0';
            }
            else {
                KidnapBenefit.disabled = false;
            }
        }

    </script>
</asp:Content>

